Forum topic

First, you must assess the actual number of patients that are candidates for a PICC in your practice. Will this be a number sufficient for you to get some actual practice within a reasonable period of time? If so, then you need to find a preceptor that can assist you with PICC placement while you are learning. This preceptor must be someone that can be present when you have a viable patient candidate.

If this is not possible, then you may have to find some other approach. There may be hospitals where you can go that will allow you to insert catheters under supervision but not be an actual employee of that hospital.This will be a very limited number but it would get you started. If that does not work, you may have to find a job on an IV/PICC Team where they are willing to train you.

 Finally, your hospital needs to have a written plan for documenting competency with this procedure, as with all procedures that represent an expansion of your current practice. So contact the education dept within your hospital to see what this competency assessment program is. Is there already a team of nurses in your facility placing PICCs? If so, then get a transfer to work on that team. I would definitely not recommend being precepted by a radiologist because of the differences in practice settings. They will use longer wires and fluoroscopy. At the bedside, you will not be using fluoro and be using shorter wires. So look for an experienced nurse to be your preceptor. 

Good luck,  

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

There is a lot more to be being a PICC nurse than the technical aspects of the procedure.  A solid background of physical assessment skills, disease state knowledge, and sound judgement are essential.  The best PICC nurses have excellent nursing experience prior to specializing in line placement.  The best way to get experience in my opinion is working on an Iv Team that places many lines and has knowledgeable clinicians to help you.  A nurse who concentrates on the technical aspects of the procedure alone is DANGEROUS! I don't know what your background is, or how long you have been a nurse. You may have noticed if you read through this forum that the nurses that contribute go by many titles, but the term "PICC Nurse" is disappearing from popularity.  They are Vascular Access Consultants, or something like that.  Get a good solid background in nursing, probably starting in ICU where you deal with multiple drugs infusing simultaneously into very sick people.  Build your knowledge base. Get a job at a hospital that has an IV Team with a good reputation.  If this is your dream, by all means go after it!  But be prepared to come to the table prepared with the knowledge base you need.  You need to consider the entire clinical picture and do a full patient assessment prior to placing ANY line.  Another position to consider for getting excellent experience is home infusion.  Good luck, but proceed slowly, with caution! That's the only way you will be an asset to this specialty instead of a liability!

Halle Utter, RN, BSN 

Intravenous Care, INC 

I agree with all posts on this one....and: do you have support from your facility? Where would you get support?

PICCs are not just lines you put in veins; they are one part of a complicated process with the end goal of providing the patient with the best possible vascular access.  Quite often the best possible vascular access is a PICC, but not always.

Patients have many other factors that must be evaluated prior to placing a PICC, and patients with PICCs require continual excellent critical thinking skills and problem-solving AFTER they're placed.  You can ultimately only learn PICC placement by actually placing them - where would you do that if you don't have the support of your facility?

You also have to be a team player with a multidisciplinary approach - with MDs, infection control, nursing staff, education, case management/discharge planning, etc.  Physicians call me now for consultations about vascular access.  This would not be so if I was just 'putting' PICCs, to quote myself.....

If you are truly interested - go for it.  Make a commitment to vascular access as a career choice; not only as something that is technically appealing.  Get the experience you need with an IV team, be persistant and patient.  You'll be of much more benefit to your patients to be fully prepared.

Mari Cordes, BS RN 

Fletcher Allen Health Care in Burlington, VT (yes, our team) also offers hands on comprehensive training, customized to each students needs. 

Also on the east coast, but if you connect with your facility with a good proposal, they may consider paying your way - wherever you decide to go.  Include in your proposal how your training will benefit patients and the hospital.

Mari Cordes, BS RN